Epidemiology and risk factors for mortality in bloodstream infection by CP-Kp, ESBL-E, Candida and CDI: A single center retrospective study
| Autor: | Francesco Giuseppe De Rosa, Lucina Fossati, Roberto Angilletta, Claudia Filippini, Giovanni Di Perri, Rossana Cavallo, Stefania Raviolo, Silvia Corcione |
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| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Male Pediatrics medicine.medical_specialty 030106 microbiology Bacteremia Neutropenia Single Center law.invention 03 medical and health sciences 0302 clinical medicine Anti-Infective Agents law Risk Factors Epidemiology Internal Medicine medicine Humans 030212 general & internal medicine Hospital Mortality Aged Candida Retrospective Studies Aged 80 and over business.industry Clostridioides difficile Incidence (epidemiology) Candidiasis Enterobacteriaceae Infections Retrospective cohort study Middle Aged bacterial infections and mycoses medicine.disease Intensive care unit Klebsiella Infections Klebsiella pneumoniae Parenteral nutrition Italy Multivariate Analysis Clostridium Infections Female business Abdominal surgery |
| Zdroj: | European journal of internal medicine. 48 |
| ISSN: | 1879-0828 |
| Popis: | Background The incidence of C. difficile infection (CDI) and of bloodstream infection (BSI) caused by Candida spp., ESBL-E-producing Enterobacteriaceae (ESBL-E) and carbapenemase-producing K. pneumoniae (CP-Kp) is associated with high mortality. Methods We conducted a single centre retrospective study on patients admitted to Molinette Hospital, Turin, Italy, from January 2013 to April 2015 with CDI or BSI caused by Candida, ESBL-E or CP-Kp. For each patient demographic, clinical and microbiological data were collected. Aims of this study were to describe epidemiology and to evaluate risk factors for in-hospital mortality in this group of patients. Results Seven hundred-eighty six cases were analyzed: 398 CDI, 137 candidemia, 125 ESBL-E BSI and 126 CP-Kp BSI. CDI, candidemia and ESBL-E BSI were more frequently reported in internal medicine wards (IMW), whilst CP-Kp were more described in intensive care unit (ICU). Sixty-six percent of patients had a previous hospitalization and the majority of patients had several medical comorbidities. In-hospital death occurred in 23.4%. Independent risk factors for mortality were antibiotic therapy before hospital admission, cardiovascular diseases, neutropenia, urinary catheter, total parenteral nutrition, SIRS and higher creatinine levels at diagnosis. Previous abdominal surgery, inflammatory bowel disease, higher serum albumin levels at the admission and fever at diagnosis were significantly associated with survival. Conclusion Our data showed that CDI, ESBL-E BSI and candidemia are more frequent in frail patients, admitted to IMW, with chronic comorbidities and broad exposure to antibiotic therapies, with the exception for CP-Kp BSI, still more common in the ICU. |
| Databáze: | OpenAIRE |
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